Mental Disorders, Private Insurance, and SSDI Benefits

精神障碍、私人保险和 SSDI 福利

• 批准号: 6383112
• 负责人: David Salkever
• 金额: $ 16.35万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6383112
• 关键词: clinical research; disability insurance; disabling disease; health care service availability; health insurance; human data; managed care; mental disorders; mental health

This project will specify and estimate econometric models of transitions from private, long-term disability (LTD) benefits to Social Security Disability insurance (SSDI) benefits by employees who are on LTD as a result of a mental disorder. Using data from individual LTD claims, the probability of transitioning to SSDI benefits will be modeled as function of: 1) individual employee, employer, and disability characteristics; 2) LTD policy provisions; 3) mental health coverage provided by the employer; 4) availability of mental health treatment resources; 5) employers' disability management efforts; and 6) interstate differences in availability of SSDI and other compensation programs. Data on SSDI costs will also be aggregated over individual claims to the employer-year level for estimating models of SSDI costs per employee (covered by LTD insurance) per year. Data for the project will pertain to approximately 1,400 employers and their 500,00 employees covered by LTD insurance. Administrative data, claims data, data from public sources, and survey data on 278 of these 1,400 employers will be analyzed. Econometric methods will include hazard (duration) regressions as well as multiple hazard models (where return to work and transition to SSDI benefits are the competing risks). Estimation of employer-level costs will use the methods for modeling health expenditures recently proposed by Manning and Mullahy. Several approaches for estimation with missing data will also be tested as strategies for combining our employer survey data with information for all 1,400 employers in the study. The empirical estimates obtained in the study will provide information on the possible implications of changes in mental health benefits and changes in benefit and compensation programs for the continuing rapid rise in SSDI costs for beneficiaries with mental disorders. Estimates will be derived of the impacts, on SSDI receipt and costs, or increased managed care/carve-out coverage, of increased geographic availability of mental health specialty care, and of employers' disability management efforts.

该项目将指定并估计从私人，长期残疾（LTD）福利过渡到社会保障残疾保险（SSDI）福利的经济学模型。使用来自单个LTD索赔的数据，将过渡到SSDI福利的可能性将建模为：1）个人雇员，雇主和残疾特征； 2）Ltd政策规定； 3）雇主提供的心理健康覆盖范围； 4）精神健康治疗资源的可用性； 5）雇主的残疾管理工作；和6）州际公路和其他薪酬计划的可用性差异。 SSDI成本的数据也将汇总在雇主年水平的单个索赔中，以估算每位雇员SSDI成本（每年有限保险）的模型。 该项目的数据将与大约1,400名雇主及其500,00名员工有关。将分析管理数据，索赔数据，来自公共资源的数据以及对这1400名雇主中278个的调查数据。计量经济学方法将包括危害（持续时间）回归以及多个危险模型（在其中恢复工作并过渡到SSDI福利是竞争风险）。 对雇主级成本的估计将使用曼宁和穆拉希最近提出的健康支出进行建模的方法。 与丢失数据的估计方法的几种方法还将被测试，作为将我们的雇主调查数据与研究中所有1400名雇主的信息相结合的策略。研究中获得的经验估计将提供有关心理健康福利变化以及福利和薪酬计划变化的可能含义的信息，以促进精神障碍受益人的SSDI成本持续快速上升。 估计将得出对SSDI收据和成本的影响，或增加托管护理/雕刻覆盖范围，增加心理健康专业护理的地理可用性以及雇主的残疾管理工作的影响。